Ovarian function during oestrogen-progestin replacement treatment in pre-menopausal women.

Thirty-five pre-menopausal women were treated for 3 mth with sequential combinations containing oestradiol valerate and levonorgestrel in two different doses. Three treatment cycles, and 2 cycles before and 2 after treatment were studied. Subjective symptoms were relieved in 62% of women during treatment. Normal secretory phase was observed in 25-53% before and 33-35% at the end of treatment. Serum FSH and the frequency of serum progesterone increase greater than 5 nmol/1 decreased, particularly during treatment with the higher dosage. Ovulations occurred during both treatments; these combinations cannot therefore be used for contraceptive purposes. In ultrasonic studies, the average volume of ovaries in which no follicles were found, was 7.6 cm3. The volume of ovaries with follicles was 10.5 cm3. The follicular growth was often defective, also in ovulatory cycles, in both treatment and control cycles. In ovulatory cycles, luteinized unruptured follicles occurred in 2% before treatment and in 5% during treatment. In anovulatory cycles, persistent follicles were observed in 13% before treatment and in 19% during treatment. The frequency of luteinized unruptured follicle (LUF) syndrome did not increase significantly in pre-menopausal women during oestrogen-progestin treatment. However, persistent follicles were frequent during anovulatory cycles. Serum oestradiol concentrations correlated significantly with the diameter of the dominant follicle. No significant changes were found in uterine volume. Both of the tested regimens are useful for treatment of pre-menopausal symptoms.

The value of endometrial cell sampling in the management of post-menopausal women.

The value of performing endometrial cytology on women receiving hormonal replacement therapy is discussed. Evidence is presented which shows that when this is routinely performed prior to beginning therapy, some 2% of women are found to have an abnormality ranging from polyps to carcinoma. When minimal dose combined oestrogen plus progestogen replacement therapy is used together with a monitoring procedure which involves routine annual Mimark endometrial sampling and curettage for abnormal cytology or bleeding, the risk of endometrial abnormality is reduced to a minimum. The benefits to be gained and the problems which detract from the use of endometrial cytology are discussed. It is recommended that every woman should have a routine cytological endometrial screening performed by a doctor experienced in the use of endometrial sampling equipment when she receives hormonal replacement therapy in the post-menopausal phase.

[Comparative clinical and morphological studies of 2 oral contraceptives containing DL-norgestrel or D-norgestre]. / Vergleichende klinische und morphologische Untersuchungen von zwei oralen Antikonzeptiva, die DL-Norgestrel beziehungsweise D-Norgestrel enthalten.

PIP: Comparison of the effects of Eugynon and Neogynon (.05 mg ethinyl estradiol with .5 mg norgestrel or with .25 mg d-norgestrel, respectively) in 272 women is reported. The 2 preparations were comparable as regards effectiveness (100%), cycle control, and endometrial and cervical morphology. No clinical or biological complications occurred, and the incidence of minor side effects was very small. The d-norgestrel preparation (Neogynon) may be preferable for metabolic reasons because of its lower steroid dose.^ieng